NHS Direct doctor says... NO testing when taking Metformin

skhanwalker · Jul 1, 2015

999sugarbabe said:
Sorry for the length of this, it is all relevent...

I felt paticularly unwell the other day, and having gone without food for over 12 hours I tested my blood. My mmol/L was 12.0, which is high (for me).

I was preparing my lunch at the time and wondered if I should still eat my main meal with this high reading, or not? My thinking being - if my reading is already high then eating could raise it even more.

So, before cooking, I thought I'd ring "111" and ask their opinion (as it was a Bank Holiday and my options were limited).
I talked with a very nice lady on the phone. She checked with her superior and came back to me to say it was OK to still eat it. She said a doctor would call me back within the next couple of hours, but if I felt worse to ring 111 again.

Sometime later, after having cooked and eaten, I got a call from another lady saying the doctor was busy but would still call me back at some point. No problem I thought.

When the doctor eventually did call me he asked some routine questions but then launched into a lecture on blood testing!
He insisted I SHOULD NOT BE TESTING at all, as I was on Metformin. According to him, nobody on Metformin should be testing as it interferes with doing so (?!).
I tried to explain I have always tested once a day, originally on my G.P.s instruction (and whilst taking Metformin). I told him the doctor stopped issuing test strips about a year ago (£££), however I have been buying them to continue testing myself (normally only once a day).
I also pointed out to him if I didn't test my blood HOW was I supposed to know whether my diabetes was "under control" or not?
I had only tested twice on this occasion as I felt so unwell. Without testing I wouldn't have known my blood sugar level was the (probable) cause of me feeling ill.

The doctor grew increasingly stroppy saying I was making up my readings, as what I had told him wasn't possible!
WHY would I do such a thing? I even agreed with him that, the longer I went without food, I would have expected my reading to get lower, not higher.

For information my reading(s) that day were:

On waking (my normal testing time) my reading was 7.4
I don't eat breakfast, as a rule.
At 1215 (before eating) and after 12 hours + without food it was 12.0
(Lunch was eaten about 1300)
At 1410 it had reduced to 8.1
At 1515 it was 5.8
I ate again at teatime.
But at 2355 it was back up at 10.4 and I was feeling quite ill again. This time I didn't phone 111, as my previous dealings with their doctor had scared me off doing so!
I live alone, and I went to bed wondering if it would go higher in my sleep and (perhaps) never wake up.

Anyway, if you are still awake after reading all this...
Has ANYONE else been told NOT to take blood glucose readings whilst using Metformin? It's the first time since being diagnosed Type 2, in 2008, that I've ever heard of it.

How the hell is a sufferer supposed to take control of their diabetes WITHOUT knowing what their blood glucose is?

Puzzled.

Absolute Rubbish! You are very correct. How will you know if you have high sugar or not without testing? I have had pre-diabetic sugar levels on and off for a few years and I have kept it in check only because of regular testing while on drugs. So many times my drugs dosage has been reduced by my GP because my sugar level was back to normal or even a little below it sometimes (good for me actually).

So, continue testing and keep health!

tomdat7 · Jul 3, 2015

Cornman said:
I have Type 2 and the one thing drummed into me was have breakfast, especially porridge, because it has slow release of energy .
I think you're poor body is being starved of energy for hours, which means it starts drawing what resources it can muster up, having gone into panic mode. This, I believe, results in a whole load of sugary stuff being sourced from the far reaches of your body, resulting in sky high blood-sugar readings. Diabetis UK called its magazine Balance for a very good reason - unless you have a balanced diet, and that means regular meals, you'll get eratic readings, which are not good for your well-being. Force yourself to have breakfast, ideally porridge and you'll quickly notice the difference.

Sorry Cornman but I have got to disagree with you concerning your recommendation of porridge for breakfast. I was told by my diabetic nurse that porridge was one of the best breakfasts a diabetic could have because of it's length of fulfillment, which I do agree with. After I had eaten my porridge I always felt lethargic which I always put down to me eating too much, and because the nurse said it was the best breakfast for diabetics I thought there was no need for me to test my BG. One morning I had my usual bowl of porridge made with skimmed milk, no sugar or sweeteners, why I decided to test I don't know but when I did I couldn't believe my eyes, the meter said 20, so I thought I had used a contaminated test strip even though I had taken it from the safe container they came in, so I tested again and it was 20, no wonder I had been feeling lethargic, the nurse had told me that if my readings were 17 and above to contact her or the diabetic nurse at my local hospital. So I didn't eat again for a few hours and checked my BG every hour and it took 4,1/2 hours for it to drop into single figures, and 6 hours before it reached 6. Before I discovered how high the readings were I would only test once a day usually after tea and was always annoyed that the readings were always 9 or more, even if I hadn't eaten at all since breakfast, so be aware of the so-called super breakfast, it certainly doesn't do for all.

Danbridge · Jul 3, 2015

I would go against doctor's orders and test anyway. Then I would find another doctor that is not so...uh...how do you call it..."stroppy".

registerlady · Jul 3, 2015

I have been on metformin for yonks and have always tested and been encouraged to do so by gp and dn.

jdmitzi · Jul 5, 2015

This is shocking to hear! I take Metform and Diamicron. I have been instructed by my private health fund and doctor, to test my blood sugar first thing in the morning and 2 hours after eating. They want me to test my blood at least twice a day to find out how the medication is affecting my blood sugar. Without regular testing you will not know how your body is responding to the medication. Ignore dangerous out-dated advice! Read up on the latest treatments and research findings. There is a lot of information out there. Metform is not a cure!. Keep testing and recording your blood sugar. It is your body so take control of your treatment and outright reject bad advice. Try to make healthier choices when you eat and eat in moderation, exercise and sleep well. We all know that for type 2 diabetes that weight and lack of exercise are risk factors. Oh and keep regular contact with a good GP that is up-to-date with the latest information and treatment. I hope you feel better soon. Good luck!

trisha68 · Jul 5, 2015

999sugarbabe said:
Sorry for the length of this, it is all relevent...

I felt paticularly unwell the other day, and having gone without food for over 12 hours I tested my blood. My mmol/L was 12.0, which is high (for me).

I was preparing my lunch at the time and wondered if I should still eat my main meal with this high reading, or not? My thinking being - if my reading is already high then eating could raise it even more.

So, before cooking, I thought I'd ring "111" and ask their opinion (as it was a Bank Holiday and my options were limited).
I talked with a very nice lady on the phone. She checked with her superior and came back to me to say it was OK to still eat it. She said a doctor would call me back within the next couple of hours, but if I felt worse to ring 111 again.

Sometime later, after having cooked and eaten, I got a call from another lady saying the doctor was busy but would still call me back at some point. No problem I thought.

When the doctor eventually did call me he asked some routine questions but then launched into a lecture on blood testing!
He insisted I SHOULD NOT BE TESTING at all, as I was on Metformin. According to him, nobody on Metformin should be testing as it interferes with doing so (?!).
I tried to explain I have always tested once a day, originally on my G.P.s instruction (and whilst taking Metformin). I told him the doctor stopped issuing test strips about a year ago (£££), however I have been buying them to continue testing myself (normally only once a day).
I also pointed out to him if I didn't test my blood HOW was I supposed to know whether my diabetes was "under control" or not?
I had only tested twice on this occasion as I felt so unwell. Without testing I wouldn't have known my blood sugar level was the (probable) cause of me feeling ill.

The doctor grew increasingly stroppy saying I was making up my readings, as what I had told him wasn't possible!
WHY would I do such a thing? I even agreed with him that, the longer I went without food, I would have expected my reading to get lower, not higher.

For information my reading(s) that day were:

On waking (my normal testing time) my reading was 7.4
I don't eat breakfast, as a rule.
At 1215 (before eating) and after 12 hours + without food it was 12.0
(Lunch was eaten about 1300)
At 1410 it had reduced to 8.1
At 1515 it was 5.8
I ate again at teatime.
But at 2355 it was back up at 10.4 and I was feeling quite ill again. This time I didn't phone 111, as my previous dealings with their doctor had scared me off doing so!
I live alone, and I went to bed wondering if it would go higher in my sleep and (perhaps) never wake up.

Anyway, if you are still awake after reading all this...
Has ANYONE else been told NOT to take blood glucose readings whilst using Metformin? It's the first time since being diagnosed Type 2, in 2008, that I've ever heard of it.

How the hell is a sufferer supposed to take control of their diabetes WITHOUT knowing what their blood glucose is?

Puzzled.

I was told not to test,i take 1000g of Metformin twice a day.I agree with you how do manage diabetes without testing, most days I feel unwell and always my blood sugar is high

DaveT2 · Jul 5, 2015

999sugarbabe said:
Sorry for the length of this, it is all relevent...

I felt paticularly unwell the other day, and having gone without food for over 12 hours I tested my blood. My mmol/L was 12.0, which is high (for me).

I was preparing my lunch at the time and wondered if I should still eat my main meal with this high reading, or not? My thinking being - if my reading is already high then eating could raise it even more.

So, before cooking, I thought I'd ring "111" and ask their opinion (as it was a Bank Holiday and my options were limited).
I talked with a very nice lady on the phone. She checked with her superior and came back to me to say it was OK to still eat it. She said a doctor would call me back within the next couple of hours, but if I felt worse to ring 111 again.

Sometime later, after having cooked and eaten, I got a call from another lady saying the doctor was busy but would still call me back at some point. No problem I thought.

When the doctor eventually did call me he asked some routine questions but then launched into a lecture on blood testing!
He insisted I SHOULD NOT BE TESTING at all, as I was on Metformin. According to him, nobody on Metformin should be testing as it interferes with doing so (?!).
I tried to explain I have always tested once a day, originally on my G.P.s instruction (and whilst taking Metformin). I told him the doctor stopped issuing test strips about a year ago (£££), however I have been buying them to continue testing myself (normally only once a day).
I also pointed out to him if I didn't test my blood HOW was I supposed to know whether my diabetes was "under control" or not?
I had only tested twice on this occasion as I felt so unwell. Without testing I wouldn't have known my blood sugar level was the (probable) cause of me feeling ill.

The doctor grew increasingly stroppy saying I was making up my readings, as what I had told him wasn't possible!
WHY would I do such a thing? I even agreed with him that, the longer I went without food, I would have expected my reading to get lower, not higher.

For information my reading(s) that day were:

On waking (my normal testing time) my reading was 7.4
I don't eat breakfast, as a rule.
At 1215 (before eating) and after 12 hours + without food it was 12.0
(Lunch was eaten about 1300)
At 1410 it had reduced to 8.1
At 1515 it was 5.8
I ate again at teatime.
But at 2355 it was back up at 10.4 and I was feeling quite ill again. This time I didn't phone 111, as my previous dealings with their doctor had scared me off doing so!
I live alone, and I went to bed wondering if it would go higher in my sleep and (perhaps) never wake up.

Anyway, if you are still awake after reading all this...
Has ANYONE else been told NOT to take blood glucose readings whilst using Metformin? It's the first time since being diagnosed Type 2, in 2008, that I've ever heard of it.

How the hell is a sufferer supposed to take control of their diabetes WITHOUT knowing what their blood glucose is?

Puzzled.

Hi like you I am type 2, I do have the support of a very good diabetic nurse at my surgery. She does give me strips but told me they are limited for T2 as theoretically they are not free. Her stand is if I am not feeling to good it right to test. I do not test every day as with my diet pretty stable.
Reading your post I would advise the most important thing is you should eat regular, I eat every 4 hours, how you go for that length of time....! I would be floored, for me breakfast is the most important. Think you should consult a doctor based on your levels something is not right.

JohnJ · Jul 5, 2015

I was reduced to to Metformin and as many say – no need to test. I have needle phobia, so great, I thought so I stopped testing. After a couple of months I felt bit unwell, tested and reading of 22!

Back to 2000mg of Metformin and 160mg Gliclazide per day, so do keep testing. Our disease is progressive therefore it is going to change!?

I am lucky that my surgery provides testing strips and appears to be more advanced than some, they even promote diabetes.co.uk

Paulabetts · Jul 5, 2015

I have been diabetic for about 10 years and was told on metformin I don't need to test was also told it was impossible to have a hypo or hyper! so why 2 weeks ago did I have a hypo with bg level of 3.2 ?? followed with a week of high near hypers as I managed to get a bladder infection within days of my hypo??

drakman · Jul 5, 2015

I did not test when I was only on Metformin, I may have learned to eat more healthily eating to the meter but I have my doubts. I have a crisis when my sugars went stupidly high and my medication was changed, It was then that I got and started eating to my meter. Up until then my sugars had been stable for 5 years without testing regularly except for my quarterly Hb1Ac
I am on gliclazide and metformin now, it is working well but I do have to test as my sugars dip and peak.
Unless you have an issue testing is pointless unless you have no control over yourself and how you eat. Be sensible and avoid it all because self testing can be inconvenient

RobOwen · Jul 5, 2015

Having been prescribed 4 x 500mg of Metformin and 4 x Gliclazide daily, I am now on a significantly reduced Metformin only (1 x 500mg daily) after 8 weeks of Newcastle diet and now LCHF. I am testing regularly to monitor the impact on how various meals affect my BG levels while I am sorting out foods that are better for me. Since I started monitoring my GP agreed to prescribe Accu-Chek Aviva test strips and I have only requested one pot of 50 per month but have bought many more myself. Last week the practice contacted me to say they can no longer prescribe that brand of test strips, but can let me have GlucoRX Nexus strips along with a freebie testing meter.

I have done a handful of tests with both devices and the readings are comparable but the analysis software for the GlucoRX is woefully lacking compared to the (paid for) Accu-Chek offering. The lancet system is also far too fiddly in comparison to Accu-Chek fastclix system.

I think I may end up just self-funding the Accu-Chek consumables myself. In the long term I will also be reducing the quantity of tests I do as my bloods stabilise.

MosheBenYehuda · Jul 5, 2015

RobOwen said:
Having been prescribed 4 x 500mg of Metformin and 4 x Gliclazide daily, I am now on a significantly reduced Metformin only (1 x 500mg daily) after 8 weeks of Newcastle diet and now LCHF. I am testing regularly to monitor the impact on how various meals affect my BG levels while I am sorting out foods that are better for me. Since I started monitoring my GP agreed to prescribe Accu-Chek Aviva test strips and I have only requested one pot of 50 per month but have bought many more myself. Last week the practice contacted me to say they can no longer prescribe that brand of test strips, but can let me have GlucoRX Nexus strips along with a freebie testing meter.

I have done a handful of tests with both devices and the readings are comparable but the analysis software for the GlucoRX is woefully lacking compared to the (paid for) Accu-Chek offering. The lancet system is also far too fiddly in comparison to Accu-Chek fastclix system.

I think I may end up just self-funding the Accu-Chek consumables myself. In the long term I will also be reducing the quantity of tests I do as my bloods stabilise.

I had a similar problem, having bought an Accu Aviva, and been given a GlucoRx by GP. I ended up bying from Home Health UK an SD Codefree, as they have the cheapest, £6.99 / 50 strips. The lancet device uses the same system as the GlucoRx, but I swaped and use the Fast-Clix as I found it to be exceptional.
The Accu strips are very expensive, so I keep them for comparison testing, as I believe they are reliable.
All the best

MosheBenYehuda · Jul 5, 2015

Paulabetts said:
I have been diabetic for about 10 years and was told on metformin I don't need to test was also told it was impossible to have a hypo or hyper! so why 2 weeks ago did I have a hypo with bg level of 3.2 ?? followed with a week of high near hypers as I managed to get a bladder infection within days of my hypo??

Hi Paula,
Diabetes is as diverse as the multitude of people having it...
In the end, being your life and your health, you must have the last word in any care plan that is being offered to you. Carefully log all your readings and discuss them with your consultant. I was first told not to test, but when I have shown my GP some strang results, and I mentioned that I feel unwell when they happen, I was told to test when I feel like that, and been given a kit and prescription strips/lancets.

graj0 · Jul 5, 2015

drakman said:
Up until then my sugars had been stable for 5 years without testing regularly except for my quarterly Hb1Ac.

HbA1c measures glycated haemoglobin, you get an overall picture of what your average blood sugar levels have been over a period of 8 - 12 weeks. It will not show you any peaks or troughs that occurred during that period of time so doesn't really show whether your BG is stable, only your HbA1c.

natureman_ · Jul 5, 2015

I'm from Canada so our medicine is probably a little different than in the UK. I'm a type 1 using insulin as well as metformin and I test up to 18+ times a day. "Helps to have good private health insurance along with our healthcare". My endocrinologist has "never" told me "not" to test. She felt it was important to stay on top of my BG's at all times. The other part of the reason she has me has me on metformin is to help with stabilizing my sugars as I had necrotizing pancreatitis and they ended up removing my pancreas and spleen so she says for me balancing my sugars is flying in the middle of a storm.

MosheBenYehuda · Jul 5, 2015

natureman_ said:
I'm from Canada so our medicine is probably a little different than in the UK. I'm a type 1 using insulin as well as metformin and I test up to 18+ times a day. "Helps to have good private health insurance along with our healthcare". My endocrinologist has "never" told me "not" to test. She felt it was important to stay on top of my BG's at all times. The other part of the reason she has me has me on metformin is to help with stabilizing my sugars as I had necrotizing pancreatitis and they ended up removing my pancreas and spleen so she says for me balancing my sugars is flying in the middle of a storm.

Welcome natureman
Quite a life story. How encouraging to know you are still in control.
Take care

RichardofYork · Jul 5, 2015

Agree with all comments posted that you should test. But probably not good idea to miss breakfast. If your fasting (overnight) BG is 7.4 in morning that is normal for T2. However that doesn't explain why it rises to 12 at noon before taking food. Is it possible your liver is dumping glycogen to raise it? It might be helpful to see a different Dr for a second opinion. Wishing you well and better control.

phil1966 · Jul 5, 2015

tomdat7 said:
Sorry Cornman but I have got to disagree with you concerning your recommendation of porridge for breakfast. I was told by my diabetic nurse that porridge was one of the best breakfasts a diabetic could have because of it's length of fulfillment, which I do agree with. After I had eaten my porridge I always felt lethargic which I always put down to me eating too much, and because the nurse said it was the best breakfast for diabetics I thought there was no need for me to test my BG. One morning I had my usual bowl of porridge made with skimmed milk, no sugar or sweeteners, why I decided to test I don't know but when I did I couldn't believe my eyes, the meter said 20, so I thought I had used a contaminated test strip even though I had taken it from the safe container they came in, so I tested again and it was 20, no wonder I had been feeling lethargic, the nurse had told me that if my readings were 17 and above to contact her or the diabetic nurse at my local hospital. So I didn't eat again for a few hours and checked my BG every hour and it took 4,1/2 hours for it to drop into single figures, and 6 hours before it reached 6. Before I discovered how high the readings were I would only test once a day usually after tea and was always annoyed that the readings were always 9 or more, even if I hadn't eaten at all since breakfast, so be aware of the so-called super breakfast, it certainly doesn't do for all.

This post perfectly illustrates the need to test irrespective of what the medical professionals might tell you!

Everyone's diabetes is unique to them and what spikes one person might not spike another (and vice-versa). This is my main bone of contention with the advice handed out by the NHS: It's completely generalised and pays no heed at all to an individual's requirement.

If I hadn't tested when I was first diagnosed I'm sure I'd be in a far worse place than I am now and I now know pretty much what I can and can't eat and I simply avoid any foods that spike me. It's a moving target though - since I got my BS under control I have found that I can eat stuff that I couldn't when I was first diagnosed so it's important to keep up with testing and continually adjust your diet to give you results that are acceptable to you personally

Ultimately, my view is that it's my body and my diabetes and I'll do what is best for me and will simply ignore anyone who tells me I'm doing it wrong when the results clearly show I'm most certainly not!

MosheBenYehuda · Jul 5, 2015

phil1966 said:
This post perfectly illustrates the need to test irrespective of what the medical professionals might tell you!

Everyone's diabetes is unique to them and what spikes one person might not spike another (and vice-versa). This is my main bone of contention with the advice handed out by the NHS: It's completely generalised and pays no heed at all to an individual's requirement.

If I hadn't tested when I was first diagnosed I'm sure I'd be in a far worse place than I am now and I now know pretty much what I can and can't eat and I simply avoid any foods that spike me. It's a moving target though - since I got my BS under control I have found that I can eat stuff that I couldn't when I was first diagnosed so it's important to keep up with testing and continually adjust your diet to give you results that are acceptable to you personally

Ultimately, my view is that it's my body and my diabetes and I'll do what is best for me and will simply ignore anyone who tells me I'm doing it wrong when the results clearly show I'm most certainly not!

Hi Phil,
You're absolutely right and on target. I couldn't have said it better myself;-) and my situation is very similar to yours.
Excellent points:-D

Scouser58 · Aug 7, 2015

Hello to all, long time no visit this ongoing problem. We the diabetics are correct, we need to test our bs, to keep things under control and keep us well and away from any unwanted nasty complications.
Diabetics Want to Test, so give them the equipment they need,,, this is a small price to pay,,, especially as the other conditions that can come along cost many more resources and money to fix and get the person well again,,,,ttfn from Karen

NHS Direct doctor says... NO testing when taking Metformin

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